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Top 10 strategies to boost efficiency

March 1, 2006
WWhy do some doctors generate significantly more production and profits despite having the same clinical time commitment, staffing levels, and facility resources as others? The key for these high-profit doctors is working smarter, not harder, through maximum efficiency.
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WWhy do some doctors generate significantly more production and profits despite having the same clinical time commitment, staffing levels, and facility resources as others? The key for these high-profit doctors is working smarter, not harder, through maximum efficiency. Below are 10 of the most important strategies to increase efficiency for greater profitability.

1) Improve clinical speed. Using improved techniques, materials, and modalities, doctors can provide needed treatment in dramatically less time these days. While many continuing-education courses may prove helpful, general dentists should particularly consider the “15-Minute Endo” and “15-Minute Crown” programs produced by Dr. Scott Perkins. To learn more, telephone Dr. Perkins at (800) 454-5161 or visit his Web site at

Moreover, orthodontists should take advantage of new faster-acting brackets and “smart wires” that can dramatically reduce treatment times.

2) Maximize patient care time. While doctors often spend the same amount of hours each week in the office, the amount of actual time devoted to patient care varies a great deal.

Unfortunately, some doctors try to “do it all,” including handling lower-level services and routine administrative and management tasks. Doctors should conduct a time and motion study chronicling their efforts for at least one week, categorizing their efforts as either patient care, activities that can be delegated, or wasted time. Eliminating wasted time, delegating lower-level tasks to trained and qualified personnel, and using the freed-up time to devote to patient care can result in tremendous productivity gains.

3)Improve procedure mix. Even doctors devoting the same number of hours to clinical care each week can have dramatic differences in production. Low-producing doctors usually are concentrating their services and treatment planning on lower-level procedures, and referring out higher-level procedures that they could perform with adequate training and instrumentation. They also are failing to offer expanded hygiene department services, including soft tissue-management services. Solving this problem can often boost annual practice profits by $50,000 to $100,000 annually.

4) Efficient scheduling.Using doctor time and block scheduling in multiple operatories can allow doctors to reach maximum efficiency. Most doctors achieve maximum productivity by scheduling their longest, big-ticket procedures in the morning, and using the afternoon for shorter, lower-level procedures.

5) Increase treatment-acceptance rates. Differences in treatment acceptance (conversion) rates can result in huge variations in productivity, even when doctors are diagnosing and treatment planning for comprehensive dentistry. Improving a practice’s treatment-acceptance rate (percentage of patients accepting treatment where treatment is recommended) for big-ticket services can have a dramatic impact on practice productivity.

Doctors can improve case-presentation skills using an oral camera and other technology involving trained staff where appropriate. Offer flexible-payment financing to reduce down payments and monthly payments, allowing patients to spread payments over an extended period. Also consider using nonrecourse third-party financing, automatic bank drafts, or automatic charging to credit cards.

6) Maximize treatment per visit.Doctors should seek to provide the maximum amount of treatment at each visit, consistent with the treatment plan. If patient finances are a concern, it is better to provide as much treatment as possible at each visit and allow payment over an extended period using the options described above. This eliminates costly patient visits where little treatment is performed, allowing the doctor to achieve efficiency goals.

7) Extend treatment intervals. Orthodontists should take advantage of tremendous advances in technology, materials, and treatment modalities to minimize the amount of time patients spend in treatment. They also should extend intervals between patient visits to the maximum extent possible without adversely affecting patient care. Many orthodontists have been able to extend time intervals between visits from the historical average of four weeks to six to 10 weeks. This has allowed them to double their patient volume without increasing patient-care time.

In general practices, doctors with an overbooked hygiene department should consider extending intervals between routine cleanings for “A” patients from six months to seven to nine months to free up time for soft-tissue management and other upper-level services. This will accomplish two things: prevent overloading the hygiene schedule and avoid becoming hygiene-dominated.

8) Increase patient education. Doctors should make maximum use of their practice’s Web site, as well as printed and video patient-education systems, to educate patients about their dental condition and recommended treatment. This provides comprehensive dissemination of all necessary information, saving valuable doctor and staff time, and increasing treatment acceptance rates.

9) Replace labor with technology. High-efficiency practices take advantage of every opportunity to replace costly labor with technology. Back-office computerization through terminals in each operatory can eliminate tremendous front-office labor. It also can help avoid loss of patient charges and coding errors, since the clinical personnel directly inputs patient information, procedure codes, and billing information. Computerizing patient records, patient-education videos, and voice-recognition software also can minimize labor needs and allow staff to perform higher-level tasks for greater efficiency.

10) Optimize facility and equipment.Doctors should make sure that they are utilizing a practice facility that allows them to operate at their maximum production. Moreover, doctors should invest in adequate equipment, including dental chairs and instrumentation, to handle emergency and overflow situations. An extra, unbooked operatory can reduce significant stress for the doctor and help generate 10 to 20 percent more clinical output. While these strategies often involve a significant investment in facility and equipment, they are cheap considering the return on investment they generate.

Editor’s Note: This article was reprinted with permissionfrom “The McGill Advisory,” a monthly newsletter devoted to tax, financial planning, investment, and practice-management matters exclusively for the dental profession. Contact John K. McGill & Co., 2810 Coliseum Centre Drive, Suite 360, Charlotte, NC 28217 or call (704) 424-9780 for more information.

John K. McGill, MBA, CPA, JD, is a tax attorney, CPA, and MBA, and the editor of “The McGill Advisory,” a monthly newsletter helping dentists to maximize profitability, slash taxes, and protect assets. The newsletter ($209 a year) and consulting information are available from John K. McGill and Company, 2810 Coliseum Centre Drive, Suite 360, Charlotte, NC 28217. Call (704) 424-9780, or visit the Web site at

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